Midgut malrotation with volvulus is a life-threatening surgical emergency. Prompt diagnosis and treatment is paramount to good outcome. Imaging plays a key role in confirming the diagnosis. A two-day-old male infant presented with bilious vomiting and was diagnosed by upper GI examination to have midgut malrotation and volvulus. The gut was ischaemic but viable at surgery. Radiological features of malrotation and volvulus are presented and discussed.